HomeMy WebLinkAboutCD 2018-0015; SIX ON MADISON; Consistency Determination (CD)•
PROJECT NAM·E: : ::::a-:t• Parcel Number(•) and A-00:Z0'"3-:3o:-i0-00 :ttf~ ~~~
• Desc~pllon of prupouJ (add .-mem W n ..... ~, qii~ ?~1:.;;;;::±r;;]? ~
L02ei7:-9=!;)tf._ ~C!Mr1%L ~~-~ ____ _;_±?> 5f!,t;~ h.,;l~· 417 d1,pc.tL~ [CVJ; CC-c'.'.7<n±s. . ~_. ___________ _
. y 'ha:' N Would you like to orally present your proposal to your assigned staff plannerlengineer? es fj 0
Please list the .ttff members you have previously spoken to regarding this project. If none, plea1e so state. Cfuc=» &.'1.c.,., __________ ._. __
: 0\/VNER NAME (Print):
, MAILING ADDRESS:
': CITY. STATE, ZIP:
TELEPHONE:
EMAIL ADDRESS: ------..._., .. ,,
*Owner"s signature lndlc1tu pennlaslon to conduct • prellmlnary
1 review for• d•velopment p,opoeal.
) IN THE PROCESS OF REVIEWING THIS APPLICATION IT MAY BE I, NECESSARY FOR MEMBERS OF CITY STAFF TO INSPECT AND
ENTER THE·PROPERTY THAT IS THE SUBJECT OF THIS
. APPLICATION. INVE CONSENT TO ENTRY FOR THIS PURPOSE. I
i CERTIFY THAT I AM THE LEGAL OWNER ANO THAT ALL THE ABOVE I INFORMATION IS T. e AND i9~RECT4TQ THE BEST OF MY
I K OWLE E. ll,J',~~':I!:!:__C rJT ~ :7UJ~II!& • ~~ (
! SIGNA RE ' . ' .
MAILING ADDRESS:
CITY, STATE, ZIP:
TELEPHONE:
EMAIL ADDRESS:
RECEIVED BY:
P-16 Pege2of2
I CERTIFY THATI AM THE LEGAL REPRESENTATIVE OF THE
OWNER AND THAT All THE ABOVE INFORMATION IS TRUE
AND CORRECT TO THE BEST OF MY KNOWLEDGE.
d
r~~= .: 1: f'i·_,:~·-0
Revised 02128ft 6
JUL 12 2018
CITY C.--C'.:,:L:: -·_c'\!J
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